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GPhC Exam '22 > CH5: INFECTIONS > Flashcards

CH5: INFECTIONS Flashcards

1
Q

Antibiotics that are contraindications to children?

A

Tetracycline CI < 12 years and breastfeeding
- Bind to teeth and bones
- Hepatotoxicity

Quinolones contraindicated = Risk of joint pain

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2
Q

antibiotics that are contraindications for pregnant women?

A
  • Tetracycline = Hepatotoxic
  • Aminoglycosides (1st/ 2nd T)
  • Metronidazole (high dose)
  • Clarithromycin
  • Chloramphenicol = Grey baby syndrome at 3rd T
  • Trimethoprim
  • Nitrofurantoin at term (28-40 w)
  • Quinolones
  • Sulphonamides
  • Glycopeptides: unless benefit > risks
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3
Q

name the antibiotics that are safe to use in pregnancy

A
  • penicillin’s
  • cephalosporins
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4
Q

state the antibiotics that have increased risk of C.diff

A
  • Clindamycin
  • Cephalosporins
  • Ciprofloxacin
  • Co-amoxiclav
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5
Q

state the antibiotics that can cause renal impairment

A

NAG TT

  • Aminoglycoside/ glycopeptides = risk of nephrotoxicity/ ototoxicity
  • Nitrofurantoin avoided at eGFR <45ml/min
  • Tetracyclines (except doxycycline and minocycline)
  • Trimethoprim
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6
Q

state the antibiotics that can cause liver impairment

A
  • Rifampicin
  • Tetracyclines
  • Metronidazole = dose reduction needed in severe hepatic impairment by 1/3rd of the normal dose.
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7
Q

Name the 1st generation drugs of cephalosporin and what it is used to treat.

A

PO
‘Fa’ e.g. cefalexin, cefadroxil

Used to Tx: UTI, Sinusitis and otitis media

Cefalexin + Warfarin = increases the risk of bleeding
- mainly gram-positive

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8
Q

Name the 2nd generation drugs of cephalosporin and what it is used to treat.

A

PO
e.g. cefoxitin, cefuroxime

Used to Tx: UTI, Sinusitis and otitis media
- mainly gram-positive

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9
Q

Name the 3rd generation drugs of cephalosporin and what it is used to treat.

A

IV
‘one, ime’

Ceftriaxone= meningitis/ gonorrhoea
Ceftazidime = pseudonomas aug. infections
- mainly gram negative

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10
Q

Name the 5th generation drugs of cephalosporin and what it is used to treat.

A
  • Ceftaroline = used in CAP and complicated soft tissue infection
  • mainly gram negative
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11
Q

side effects of cephalosporins

A
  1. 2nd/ 3rd generations of cephalosporins = can lead to abx associated colitis
  2. C.diff infection
  3. Avoid in patients with hypersensitivity to penicillin and other beta-lactams due to cross sensitivity
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12
Q

what type of spectrum is chloramphenicol?

A

broad spectrum

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13
Q

indication and age used for chloramphenicol?

A
  • Tx: Eye infections such as conjunctivitis
  • OTC= 2years +
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14
Q

when to AVOID the use of chloramphenicol?

A
  • pregnancy in 3rd Trimester (28-40 weeks)
  • risk of grey baby syndrome
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15
Q

what type of spectrum is clindamycin?

A

narrow spectrum, gram-positive and anaerobes

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16
Q

indication of clindamycin

A
  • mainly used for skin and soft tissue infections
  • LRTIs
  • Osteomyelities
  • Acne vulgaris
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17
Q

cautions for use of clindamycin

A
  1. Can cause abx-associated colitis
    • stop in severe/prolonged/bloody diarrhoea
    • more common in elderly
  2. Greater risk of C.diff
    • seek specialist advice if can’t be stopped
  3. Can cause metallic taste if taken orally
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18
Q

contraindications of clindamycin

A
  • Acute porphyria’s: intermittent attacks of abdominal pain and neurological symptoms
  • GI disease e.g., colitis
19
Q

what are the indications of clindamycin

A
  • erythromycin
  • CYP enzyme inhibitors - SICKFACES.COM GAVID
20
Q

what are the indications of clindamycin?

A
  • erythromycin
  • CYP enzyme inhibitors - SICKFACES.COM GAVID
21
Q

what type of spectrum is linezolid?

A

narrow spectrum, gram positive

22
Q

safety information of linezolid & monitoring advice

A
  • Risk of severe optic neuropathy
  • report a visual disturbance
  • monitored regularly if treatment is more than 28 days
  • Risk of blood disorders
  • Monitor full blood counts weekly
  • Monitor regularly if treatment is more than 10-14 days
23
Q

drug interactions of linezolid

A

linezolid- is a reversible MAOI inhibitor (avoid antidepressants).

  1. Tyramine-rich foods: mature cheese, yeast extra, and marmite = can cause hypertensive crisis
  2. SSRIs, 5-HT1 agonist (triptans), TCAs, Lithium, MAOIs = can cause serotonin syndrome
24
Q

state the doses differences of macrolides

A

Clarithromycin (BD)
Azithromycin (OD)
Erythromycin (QDS)

25
Q

what type of spectrum are macrolides?

A

Broad spectrum Abx

26
Q

name the macrolide that is preferred in pregnancy?

A

erythromycin

27
Q

what drugs should be cautioned in myasthenia gravis?

A

MATQ

Macrolides
Aminoglycosides (gentamicin)
Tetracyclines
Quinolones

28
Q

side effects of macrolides?

A
  1. C.diff
  2. QT prolongation
  3. Ototoxicity = in large doses
  4. Hepatotoxicity
  5. GI disturbances
29
Q

what are the drug interactions of macrolides?

A

CYP450 enzyme inhibitor
1. Statins = discontinue use of statins until course of abx is completed = increases risk of myopathy
2. Warfarin = increases risk of bleeding

30
Q

name the drugs when used with macrolides can cause hypokalemia

A
  • Loop/ thiazide diuretics
  • Steroids
  • Salbutamol
  • Theophylline
31
Q

name the drugs when used with macrolides can cause QT prolongation

A

TCAs
SSRIs
Sotalol
Amiodarone
Haloperidol
Antifungals

32
Q

what type of cover does metronidazole target?

A

anaerobic cover

33
Q

what are the side effects of metronidazole

A
  1. N/V = to take with or after food to reduce this
  2. Has a metallic taste
  3. Brown urine = normal SE
  4. Furry tongue
  5. Dry mouth
34
Q

what can you advise a patient who is wondering if they can have alcohol during the course of their metronidazole treatment?

A

Avoid = SE disulfiram reaction (N/V, flushing) = hangover effect.

Can have alcohol 48 hours after treatment.

35
Q

what are the drug interactions of metronidazole?

A
  • Warfarin = increased bleeding risk
  • Rifampicin and phenytoin reduce metronidazole concentration
  • Lithium toxicity with metronidazole
36
Q

advise on dosing for a patient with a severe liver impairment who has been prescribed metronidazole?

A

reduce dose by 1/3 of daily dose and give OD

37
Q

state the side effects of taking high doses or prolonged doses of metronidazole?

A

encephalopathy
seizures
peripheral and optic neuropathy

CI: in pregnancy

38
Q

name the pathogen that causes UTI

A

E.coli

39
Q

name the pathogen that causes thrush

A

Candida Albican

40
Q

name the pathogen that causes cellulitis

A

Staph Aures

41
Q

name the pathogen that causes meningitis

A

Strep Pneumoniae

42
Q

name the pathogen that causes CAP

A

Strep Pneumoniae

43
Q

name the pathogen that causes CAP

A

GPhC Exam '22 (16 decks)

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